A DO’s guide to navigating the visa process when applying to residency

To most, Match Day is a rewarding time. It marks the culmination of years of effort and immense hard work. Unfortunately, if you are a foreign student (i.e., non-green card holding, non-U.S. citizen), Match is not the end of the road for you. Following the Match, you will likely begin the process of applying for a visa that will allow you to stay in the U.S. while you complete your residency training.

The percentage of foreign students graduating from DO schools increased by 32% from the 2019-2020 academic year to 2023-2024, from 96 graduates in 2020 to 127 graduates in 2024, according to the American Association of Colleges of Osteopathic Medicine (AACOM).

This article is an objective guide for U.S.-based foreign medical students on the process of applying for a J-1 visa. Please note that the Trump administration has recently made changes to U.S. visas and more changes may be coming; as the situation is rapidly evolving, you will want to confirm that all information shared here is still correct when you apply for your visa.

Known officially as the Exchange Visitor Visa, the J-1 visa is a type of non-immigrant visa. There are, of course, some programs that offer H-1B visas (which allows U.S. employers to temporarily employ foreign workers) and some can even start residency under an extension of their F-1 student visa called Optional Practical Training (OPT).

As previously mentioned, the Trump administration recently changed the rules for H-1B visas; employers are now required to pay a $100,000 fee when they hire new employees on H-1B visas.

Healthcare organizations are currently urging the administration to exempt physicians from the new fee. Also, the AOA is advocating to support J-1 physicians; more details about the AOA’s advocacy are below.

Soon after matching, your school’s program liaison will reach out to you about the process of applying for a J-1 visa. You will first need to sign your residency’s offer letter. Once officially confirmed by your program, the liaison can then initiate the lengthy process to get your DS-2019 approval from the Educational Commission for Foreign Medical Graduates (ECFMG). The DS-2019, or “Certificate of Eligibility for Exchange Visitor (J-1) Status,” signifies that you meet all the requirements set forth by your J-1 sponsor and are eligible to apply for a J-1 visa.

The ECFMG was established in 1956 to help vet foreign medical professionals interested in practicing in the U.S. The ECFMG runs a certification program for foreign nationals who attended international medical schools; the organization also runs an exchange visitor sponsorship program to sponsor international physicians (like me) who need J-1 visas for their residency training. As part of this program, the J-1 physicians are required to return to their home country after residency for at least two years.

The actual process to apply for the J-1 visa is initiated by completing a form called the DS-160. Once approved, one can schedule their visa interview at the corresponding embassy. For those who cannot travel, there are additional forms that can be filled out and fees that can be paid to circumvent this requirement.

Timelines

The earliest the ECFMG can give you a DS-2019 is six months prior to your start date. Most people participating in the match should expect instructions to access the ECFMG in April. Once submitted, approval for the DS-2019 can take four to six weeks (and is likely to take longer). The key is to do your due diligence and submit necessary information as early as possible.

What to prepare

• A signed offer letter: This is to confirm that you have been officially accepted into an accredited program.
• A scanned copy of your passport: Certain pages, such as the biometrics page or the one with your visa stamps, will be most pertinent. Pro tip—make sure your passport is not expiring within the next six months, as it may not be accepted if that is the case.
• I-94 Arrival/Departure Record: Make sure this is up to date.
• A statement of need letter: Contact your home country’s Ministry of Health/Health Department to get a letter vouching for you. It’s essentially a show of support from your country stating that they endorse your aspiration to train in the U.S. and intend to allow you to return afterwards. The requirements and timeline for this letter will vary based on your country, so research and be prepared.
• A form describing your Statement of Educational Objectives (SEO) must be submitted. This is a place to outline your short-term and long-term training plans as well as your anticipated stay in the U.S.
• An updated CV and a recent passport photo are commonly requested as well.

Stay informed

Please note that this list is not exhaustive. It may vary based on the program and the applicant’s country of origin, and it is subject to change by the ECFMG. Please be sure to double-check the current requirements and guidelines from the ECFMG.

As the number of foreign students attending DO schools is increasing, information like this is more important than ever to share to help prepare them for the next stage of their medical training in the U.S.

AOA is working to protect J-1 physicians and patient care

The AOA, along with the Group of Six (organizations that represent the nation’s frontline physicians), submitted comments to the U.S. Department of Homeland Security (DHS) opposing a proposed rule that would end the “duration of status” policy for nonimmigrant visa holders, including J-1 physicians in graduate medical education (GME) programs. The comments warned that replacing the current system with a fixed admission period would have immediate and destabilizing effects on hospitals, training programs and patient care.

Each year, more than 17,000 J-1 physicians train in hospitals nationwide, delivering critical care in family medicine, pediatrics, internal medicine, psychiatry, OB-GYN and surgery. The proposed rule would require these physicians to seek visa extensions mid-training, creating delays, uncertainty and potential disruptions in patient care, particularly in rural and underserved areas that rely on these physicians most.

The comments urge DHS to exclude J-1 physicians from the rule, emphasizing that they are already highly vetted, compliant and essential to addressing physician shortages. Read the full comments to learn how the AOA continues to advocate for policies that strengthen the physician workforce and ensure patients have access to consistent, high-quality care.

Related reading:

From nursing to NYITCOM: A Filipina physician’s quest for DO excellence

Practicing medicine in New Zealand: Tackling 3 misconceptions about working abroad